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Non transplant bronchiolitis obliterans

Y Yamada, E Vandermeulen, T Heigl, J Somers, A Vaneylen, S E Verleden, H Bellon, S De Vleeschauwer, E K Verbeken, D E Van Raemdonck, R Vos, G M Verleden, W Jungraithmayr, B M Vanaudenaerde
The single most important cause of late mortality after lung transplantation is chronic lung allograft dysfunction (CLAD). However, the pathological development of CLAD was not as simple as previously presumed and subclassification phenotypes, bronchiolitis obliterans syndrome (BOS) and restrictive CLAD (rCLAD), have been introduced. We want to re-investigate how CLAD manifests in the murine orthotopic lung transplant model and investigate the role of interleukin 17A (IL-17A) within this model. Orthotopic LTx was performed in CB57Bl6, IL-17 WT and IL-17 KO mice...
October 10, 2016: Transplant Immunology
J W Awori Hayanga, Jonathan K Aboagye, Heather K Hayanga, James D Luketich, Jonathan D'Cunha
BACKGROUND: In this study we sought to determine survival rates after use of extracorporeal membrane oxygenation (ECMO) as a bridge to lung re-transplantation (re-LT). METHODS: Propensity-adjusted analysis was performed on data from the Scientific Registry of Transplant Recipients (SRTR) to evaluate survival in recipients between the years 1988 and 2012, based on the use of ECMO before re-LT. RESULTS: A total of 854 adult re-LT recipients were identified...
July 2016: Journal of Heart and Lung Transplantation
Felix Doellinger, Oliver Weinheimer, Isabella Zwiener, Eckhard Mayer, Roland Buhl, Ute Lina Fahlenkamp, Christoph Dueber, Tobias Achenbach
BACKGROUND: The aim of our retrospective study was to determine whether a dedicated software for assessment of airway morphology can detect differences in airway dimensions between patients with and without bronchiolitis obliterans syndrome (BOS), regarded as the clinical correlate of chronic lung allograft rejection. METHODS: 12 patients with and 14 patients without diagnosis of BOS were enrolled in the study. Evaluation of bronchial wall area percentage (WA%) and bronchial wall thickness (WT) in all follow-up CT scans was performed using a semiautomatic airway assessment tool...
August 2016: European Journal of Radiology
N Tanaka, Y Kunihiro, T Kobayashi, T Yujiri, S Kido, K Ueda, N Matsunaga
Idiopathic pneumonia syndrome (IPS) is an acute lung dysfunction of non-infectious aetiology and a severe complication following haematopoietic stem cell transplantation (HSCT). Recently, the American Thoracic Society (ATS) updated the concept of IPS and extended the concept to a wider range; it defined IPS as "an idiopathic syndrome of pneumopathy after HSCT, with evidence of widespread alveolar injury and in which infectious aetiologies and cardiac dysfunction, acute renal failure, or iatrogenic fluid overload have been excluded...
October 2016: Clinical Radiology
S K Shah, K J McAnally, L Seoane, G A Lombard, S G LaPlace, S Lick, G S Dhillon, V G Valentine
PURPOSE: Non-tuberculous mycobacteria (NTM) are important pathogens in lung transplant recipients. This study describes the spectrum of NTM respiratory tract infections and examines the association of NTM infections with lung transplant complications. METHODS: Data from 208 recipients transplanted from November 1990 to November 2005 were analyzed. Follow-up data were available to November 2010. Lung infection was defined by bronchoalveolar lavage, sputum, or blood cultures in the appropriate clinical setting...
August 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Stijn E Verleden, Bart M Vanaudenaerde, Robin Vos, Geert M Verleden
Being involved in clinical practice and research concerning chronic lung allograft dysfunction (CLAD) nowadays is an extremely complicated matter. It used to be more simple: When a lung transplant recipient presented with a persistent decline in pulmonary function for which no other cause could be identified, the diagnosis of bronchiolitis obliterans syndrome (BOS) was made. BOS patients were typically obstructive and non-responsive to therapies. Spirometric and pathological findings not consistent with this typical presentation were mostly discarded (1)...
June 15, 2016: American Journal of Transplantation
Kevin Budding, Eduard A van de Graaf, Tineke Kardol-Hoefnagel, Johanna M Kwakkel-van Erp, Bart D Luijk, Erik-Jan D Oudijk, Diana A van Kessel, Jan C Grutters, C Erik Hack, Henderikus G Otten
CD59 is a complement regulatory protein that inhibits membrane attack complex formation. A soluble form of CD59 (sCD59) is present in various body fluids and is associated with cellular damage after acute myocardial infarction. Lung transplantation (LTx) is the final treatment for end-stage lung diseases, however overall survival is hampered by chronic lung allograft dysfunction development, which presents itself obstructively as the bronchiolitis obliterans syndrome (BOS). We hypothesized that, due to cellular damage and activation during chronic inflammation, sCD59 serum levels can be used as biomarker preceding BOS development...
2016: Scientific Reports
Denise Traxler, Thomas Schweiger, Stefan Schwarz, Magdalena Maria Schuster, Peter Jaksch, Gyoergy Lang, Peter Birner, Walter Klepetko, Hendrik Jan Ankersmit, Konrad Hoetzenecker
BACKGROUND: Chronic lung allograft dysfunction (CLAD), presenting as bronchiolitis obliterans syndrome (BOS) or restrictive allograft syndrome (RAS) is the major limiting factor of long-term survival in lung transplantation. Its pathogenesis is still obscure. In BOS, persistent alloimmune injury and chronic airway inflammation are suggested. One of the main tasks of the lymphatic vessel (LV) system is the promotion of immune cell trafficking. The formation of new LVs has been shown to trigger chronic allograft rejection in kidney transplants...
May 10, 2016: Transplantation
Catherine H Miele, Kristin Schwab, Rajeev Saggar, Erin Duffy, David Elashoff, Chi-Hong Tseng, Sam Weigt, Deepshikha Charan, Fereidoun Abtin, Jimmy Johannes, Ariss Derhovanessian, Jeffrey Conklin, Kevin Ghassemi, Dinesh Khanna, Osama Siddiqui, Abbas Ardehali, Curtis Hunter, Murray Kwon, Reshma Biniwale, Michelle Lo, Elizabeth Volkmann, David Torres Barba, John A Belperio, David Sayah, Thomas Mahrer, Daniel E Furst, Suzanne Kafaja, Philip Clements, Michael Shino, Aric Gregson, Bernard Kubak, Joseph P Lynch, David Ross, Rajan Saggar
RATIONALE: Consideration of lung transplantation in patients with systemic sclerosis (SSc) remains guarded, often due to the concern for esophageal dysfunction and the associated potential for allograft injury and suboptimal post-lung transplantation outcomes. OBJECTIVES: The purpose of this study was to systematically report our single-center experience regarding lung transplantation in the setting of SSc, with a particular focus on esophageal dysfunction. METHODS: We retrospectively reviewed all lung transplants at our center from January 1, 2000 through August 31, 2012 (n = 562), comparing the SSc group (n = 35) to the following lung transplant diagnostic subsets: all non-SSc (n = 527), non-SSc diffuse fibrotic lung disease (n = 264), and a non-SSc matched group (n = 109)...
June 2016: Annals of the American Thoracic Society
Ryan Flynn, Katelyn Paz, Jing Du, Dawn K Reichenbach, Patricia A Taylor, Angela Panoskaltsis-Mortari, Ante Vulic, Leo Luznik, Kelli K P MacDonald, Geoffrey R Hill, Melanie S Nyuydzefe, Jonathan M Weiss, Wei Chen, Alissa Trzeciak, Jon S Serody, Ethan G Aguilar, William J Murphy, Ivan Maillard, David Munn, John Koreth, Corey S Cutler, Joseph H Antin, Jerome Ritz, Samuel D Waksal, Alexandra Zanin-Zhorov, Bruce R Blazar
Chronic graft-versus-host disease (cGVHD) remains a major complication following allogeneic bone marrow transplantation (BMT). The discovery of novel therapeutics is dependent on assessment in preclinical murine models of cGVHD. Rho-associated kinase 2 (ROCK2) recently was shown to be implicated in regulation of interleukin-21 (IL-21) and IL-17 secretion in mice and humans. Here, we report that the selective ROCK2 inhibitor KD025 effectively ameliorates cGVHD in multiple models: a full major histocompatibility complex (MHC) mismatch model of multiorgan system cGVHD with bronchiolitis obliterans syndrome and a minor MHC mismatch model of sclerodermatous GVHD...
April 28, 2016: Blood
Adam Gassas, Joerg Krueger, Irina Zaidman, Tal Schechter, Hayley Craig-Barnes, Muhammad Ali, Nades Palaniyar
It is plausible that infections post-hematopoietic SCT play a role in the pathogenesis of BOS. A prospective study for children with history, questionnaire, examination, PFTs, and blood counts at one, three, six, nine, 12, 18, and 24 months post-SCT was conducted. Between September 2009 and September 2011 (n = 39), six developed BOS at 200 days (range 94-282), three patients had probable clinical respiratory infection, and all six had higher neutrophil count compared to non-BOS patients (4.7 vs. 2.4 at three months and 6...
March 2016: Pediatric Transplantation
X Liu, Z Yue, J Yu, E Daguindau, K Kushekhar, Q Zhang, Y Ogata, P R Gafken, Y Inamoto, A Gracon, D S Wilkes, J A Hansen, S J Lee, J Y Chen, S Paczesny
Improved diagnostic methods are needed for bronchiolitis obliterans syndrome (BOS), a serious complication after allogeneic hematopoietic cell transplantation (HCT) and lung transplantation. For protein candidate discovery, we compared plasma pools from HCT transplantation recipients with BOS at onset (n = 12), pulmonary infection (n = 16), chronic graft-versus-host disease without pulmonary involvement (n = 15) and no chronic complications after HCT (n = 15). Pools were labeled with different tags (isobaric tags for relative and absolute quantification), and two software tools identified differentially expressed proteins (≥1...
August 2016: American Journal of Transplantation
L-M Lücker, T Rochat, S Masouridi-Levrat, D Adler
Non-infectious pulmonary complications following hematopoietic stem cell transplantation are entities occuring early or late, depending on whether they occur before or after 100 days post-transplantation. They have firstly to be differentiated from infectious complications, which is not always easy, as their clinical and radiological aspects can mimic a viral or bacterial pneumonia. Corticosteroids are the most given treatment but a significant subset of patients have a fatal outcome. This article will review the clinical, radiological, functionnal features and the therapeutic options of six entities (engraftment syndrome, diffuse alveolar hemorrage, idiopathic pneumonia syndrome, organizing pneumonia, bronchiolitis obliterans, post-transplantation lympho-proliferative disease)...
November 18, 2015: Revue Médicale Suisse
William Dean Wallace, Ning Li, Claus B Andersen, A Valeria Arrossi, Medhat Askar, Gerry J Berry, Matthew M DeNicola, Desley A Neil, Elizabeth N Pavlisko, Elaine F Reed, Myriam Remmelink, S Sam Weigt, Birgit Weynand, Jennifer Q Zhang, Marie M Budev, Carol F Farver
BACKGROUND: The diagnosis of antibody-mediated rejection (AMR) in the lung transplant is still an area under investigation. We performed a blinded multicenter study to determine if any statistically significant histologic findings in transbronchial biopsy specimens from lung transplant patients correlate with the presence of donor-specific antibodies (DSAs). METHODS: We asked 9 pathologists with experience in lung transplantation to evaluate 161 lung transplant biopsy specimens for various histologic parameters...
January 2016: Journal of Heart and Lung Transplantation
Francisco A Guzman-Pruneda, Yishay Orr, Jeffrey G Trost, Wei Zhang, Shailendra Das, Ernestina Melicoff, Jennifer Maddox, Melissa Nugent, Carlos M Mery, Iki Adachi, Marc G Schecter, George B Mallory, David L Morales, Jeffrey S Heinle, Emmett D McKenzie
BACKGROUND: Long-term success in pediatric lung transplantation is limited by infection and bronchiolitis obliterans syndrome (BOS). The bilateral sequential lung transplantation (BSLT) technique may result in airway ischemia leading to bronchial stenosis, dehiscence, or loss of small airways. En bloc lung transplant (EBLT) with bronchial artery revascularization (BAR) minimizes airway ischemia, thus promoting superior airway healing. BAR also allows for safe tracheal anastomosis, circumventing the need for bilateral bronchial anastomoses in small children...
January 2016: Journal of Heart and Lung Transplantation
Hyojin Kim, Yoon Kyung Jeon, Hyun Joo Lee, Young Tae Kim, Doo Hyun Chung
Recently, the numbers of lung transplantation (LT) has been increased in Korea. However, post-LT outcome has not been successful in all patients, which may be partially affected by the primary lung disease. Therefore comprehensive understanding in original pathological diagnosis of patients with LT would be needed for achieving better clinical outcome. To address this issue, we performed clinico-pathological analysis of the explanted lungs from 29 patients who underwent LT over a 9-yr period in Seoul National University Hospital...
October 2015: Journal of Korean Medical Science
P Cameli, E Bargagli, A Fossi, D Bennett, L Voltolini, R M Refini, G Gotti, P Rottoli
BACKGROUND: Exhaled nitric oxide (eNO) and carbon monoxide (eCO) are markers of pulmonary inflammation associated with acute graft rejection and lung infections in lung transplant (LTX) recipients. Regarding eNO and eCO levels in LTX patients affected by bronchiolitis obliterans syndrome (BOS), published data are discordant. OBJECTIVES: We aim to evaluate eNO at multiple flows, alveolar concentration of nitric oxide (CalvNO), maximum conducting airway wall flux (J'awNO) and eCO levels in LTX patients to assess the potential role of these parameters in BOS evaluation...
September 2015: Respiratory Medicine
Kyung-Wook Jo, Shinkyo Yoon, Jin Woo Song, Tae Sun Shim, Sei Won Lee, Jae Seung Lee, Dae-Young Kim, Je-Hwan Lee, Jung-Hee Lee, Yunsuk Choi, Kyoo-Hyung Lee
The aim of this study was to determine whether prophylactic azithromycin treatment prevents bronchiolitis obliterans syndrome (BOS) after hematopoietic stem cell transplantation (HCT). A series of 1187 patients who underwent HCT between December 1993 and November 2013 at our tertiary referral center in South Korea were enrolled. The median age of these patients was 39.0 years, and 668 (56.3 %) were men. Acute leukemia was the most common indication for HCT. During a median follow-up of 30.7 months after HCT, BOS was diagnosed in 82 patients (6...
September 2015: International Journal of Hematology
S Dirou, P Germaud, S Bruley des Varannes, A Magnan, F-X Blanc
Gastroesophageal reflux disease (GERD) frequently occurs in association with chronic respiratory diseases although the casual link is not always clear. Several pathophysiological and experimental factors are considered to support a role for GERD in respiratory disease. Conversely, respiratory diseases and bronchodilator treatment can themselves exacerbate GERD. When cough or severe asthma is being investigated, GERD does not need to be systematically looked for and a therapeutic test with proton pump inhibitors is not always recommended...
December 2015: Revue des Maladies Respiratoires
Bernhard Gohrbandt, Gregor Warnecke, Stefan Fischer, Andre R Simon, Jens Gottlieb, Adelheid Niehaus, Dietmar Böthig, Axel Haverich, Martin Strueber
OBJECTIVE: Experimental and clinical studies have indicated a beneficial effect of retrograde lung preservation on post-transplant results. Accordingly, we conducted a non-randomized trial. METHODS: A total of 209 consecutive recipients transplanted with low-potassium dextrane (LPD)-preserved lungs were eligible for analysis. Antegrade lung preservation (AP) was performed in 173 patients and retrograde in situ perfusion (RP) in 36 patients using low-potassium dextrane solution in all cases...
January 2016: European Journal of Cardio-thoracic Surgery
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